_Cranium_
Blessed
Note:
1. This is a guide, nothing more. The existence of this thread does not necessitate you to use what is written, nor is it a call-out to provide more immersion or realism. I am simply creating this to hopefully give those who wish it, some information on common methods of death outside of battle.
2. This is also not an invitation for you to give your character every illness under the sun. Many real individuals have and do suffer from these, so I ask you to have respect if you do decide to employ these in your roleplay. This is not a catch all guide, but one that represents the common methods of death historically - please do some extra research as to the effect of your characters quality of life on their health. Please be considerate, do your research, and handle the situations with care.
3. I am discussing these in the absence of Formistry. I recognise that health and physiology does not exist within a vacuum in Altera, and I do not intend for this guide to make anyone's life more painful. I personally feel it could add a sense of nuance to the school, but as always, it is entirely up to the individual's discretion.
4. I have compiled this guide based on common every day threats to historical, 14th century European life. I have tried my best to give clarity to the rarity and harm they may cause. To my understanding, many real life illnesses are present in the lore of Altera. If not, I'd massively appreciate lore team to contact me and make me aware - I'd be more than happy to remove that which is not canon.
5. This can be somewhat graphic, so I will include most of the information in spoilers. I by no means claim to be a doctor, however I am studying biology and have a personal interest in pathology - so this is not a place to self-diagnose yourself with some disease. Go see a doctor.
So your character has been on the front-lines, doing this and that, fighting valiantly for his house and his family. Yet they have suffered a slice on the thigh with a rusty blade. What will become of him? Or perhaps you’re a simple commoner, scrounging about for food. Maybe you’re a hearty nobleman who has probably had a bit too much to drink, and stumbled down the stairs.
Health and physiology play a crucial aspect in roleplay, and thus deserve its dues. It is unfair to only just acknowledge your character dying in the face of violence, battle, or in the shadows. We must also consider the implications of daily life, general health and hygiene, foodstuffs, and overall working days. This guide is not intended to tell you that your character should die if faced by one of these. For it is the very nature of roleplay that most characters end up being an exception to some rule or another. That is all well and good, however, not every character should be the exception to the rule - Blarg made an excellent point in his guide that it’s okay, and even fun, to lose. Albeit he was speaking of combat, but my point still stands. Roleplaying illnesses, health issues and pathology is something I implore many to consider. We should not view illnesses as necessarily a negative thing, but an interesting point to add to a dynamic - a sudden death of a ruler by heart attack, or perhaps an infantile death due to poor midwifery.
I will also reference Naelwyn's guide from a while ago which discusses the issue of blood loss. So I’d like to give them thanks for providing support for this thread. I will also more than likely not consider diseases caused by genetics in this thread as that is a field of study in its own - with incredible nuance and distinct traits. However, I will probably discuss illnesses that can possibly be amplified by genes. Please also consider that most pathological knowledge is incredibly limited during the 14th century, and while you may roleplay out symptoms and whatnot, please try not to meta-game by knowing what the disease is immediately.
These are all very real, very common, and very life threatening diseases/methods of death. This is especially apparent considering most of these could not be adequately treated before the onset of modern Western medicine in the late 19th, early 20th century.
Traumatic Injuries1. This is a guide, nothing more. The existence of this thread does not necessitate you to use what is written, nor is it a call-out to provide more immersion or realism. I am simply creating this to hopefully give those who wish it, some information on common methods of death outside of battle.
2. This is also not an invitation for you to give your character every illness under the sun. Many real individuals have and do suffer from these, so I ask you to have respect if you do decide to employ these in your roleplay. This is not a catch all guide, but one that represents the common methods of death historically - please do some extra research as to the effect of your characters quality of life on their health. Please be considerate, do your research, and handle the situations with care.
3. I am discussing these in the absence of Formistry. I recognise that health and physiology does not exist within a vacuum in Altera, and I do not intend for this guide to make anyone's life more painful. I personally feel it could add a sense of nuance to the school, but as always, it is entirely up to the individual's discretion.
4. I have compiled this guide based on common every day threats to historical, 14th century European life. I have tried my best to give clarity to the rarity and harm they may cause. To my understanding, many real life illnesses are present in the lore of Altera. If not, I'd massively appreciate lore team to contact me and make me aware - I'd be more than happy to remove that which is not canon.
5. This can be somewhat graphic, so I will include most of the information in spoilers. I by no means claim to be a doctor, however I am studying biology and have a personal interest in pathology - so this is not a place to self-diagnose yourself with some disease. Go see a doctor.
So your character has been on the front-lines, doing this and that, fighting valiantly for his house and his family. Yet they have suffered a slice on the thigh with a rusty blade. What will become of him? Or perhaps you’re a simple commoner, scrounging about for food. Maybe you’re a hearty nobleman who has probably had a bit too much to drink, and stumbled down the stairs.
Health and physiology play a crucial aspect in roleplay, and thus deserve its dues. It is unfair to only just acknowledge your character dying in the face of violence, battle, or in the shadows. We must also consider the implications of daily life, general health and hygiene, foodstuffs, and overall working days. This guide is not intended to tell you that your character should die if faced by one of these. For it is the very nature of roleplay that most characters end up being an exception to some rule or another. That is all well and good, however, not every character should be the exception to the rule - Blarg made an excellent point in his guide that it’s okay, and even fun, to lose. Albeit he was speaking of combat, but my point still stands. Roleplaying illnesses, health issues and pathology is something I implore many to consider. We should not view illnesses as necessarily a negative thing, but an interesting point to add to a dynamic - a sudden death of a ruler by heart attack, or perhaps an infantile death due to poor midwifery.
I will also reference Naelwyn's guide from a while ago which discusses the issue of blood loss. So I’d like to give them thanks for providing support for this thread. I will also more than likely not consider diseases caused by genetics in this thread as that is a field of study in its own - with incredible nuance and distinct traits. However, I will probably discuss illnesses that can possibly be amplified by genes. Please also consider that most pathological knowledge is incredibly limited during the 14th century, and while you may roleplay out symptoms and whatnot, please try not to meta-game by knowing what the disease is immediately.
These are all very real, very common, and very life threatening diseases/methods of death. This is especially apparent considering most of these could not be adequately treated before the onset of modern Western medicine in the late 19th, early 20th century.
This area covers any "physical" infliction of harm on yourself or another that can prove dangerous. These are not necessarily deadly by nature, but can cause harm and death in the right circumstance. Keep in mind that physical hygiene was not what it currently is, and death through minor cuts were common.
Tetanus:
Other Names: Lockjaw
Infection: Introduction via puncture wounds (penetrative trauma). It is more common in hotter, damp climates with organically rich soil, typically fertilised by manure. It is typical to contract tetanus from rusted material due to the organism thriving in conditions that lack oxygen (rust typically consumes oxygen in its generation, making it an obvious indicator).
Symptoms: Mild spasms occur in the jaw (leading to the name lockjaw). Spasms can spread to facial muscles, as well as the chest, neck, back, abdominal and buttocks. Other symptoms include fever, headache, irritability, breathing problems, burning sensation from urination, urine retention, and incontinence.
Description: The spasm of back muscles causes the characteristic arching of the back, a rather disturbing sight. The farther the entry sight to the central nervous system, the longer it takes to incubate the pathogen - from around 10 days to several months. It also occurs in newborns whose umbilical stump has not been cut correctly, or cut with equipment that has not been sterilised.
Death: Mortality rate for tetanus, even treated, is usually around 10%. This is usually due to spasming of muscles, which may present breathing issues, causing respiratory failure and asphyxiation.
Blood Loss:
For more detail:
https://hollowworld.co.uk/threads/more-lengthy-tutorial-human-body-and-injury-blood-loss.27415/
However, to summarise:
-The adult body circulates around 5 litres of blood every minute
-Blood loss is caused by either trauma, a medical condition, or a combination of both
-Hemorrhaging (blood loss) is typically divided into Class I, II, III and IV
-Class I involves up to 15% blood loss (750mls or 1.6 pints) and typically does not affect vital signs, but can cause dizziness and lethargy
-Class II involves up to 15-30% blood loss (750mls-1500mls or 1.6-3.2 pints). This typically causes rapid heart beat, with the skin becoming pale and cool to the touch.
-Class III involves up to 30-40% blood loss (1500mls-2000mls or 3.2-4.2 pints). Blood pressure drops, heart beat increases and the individual enters shock. Blood transfusion is typically necessary at this point.
-Class IV involves any more than 40% blood loss (>2000mls or >4.2 pints). The individual is incredibly close to death and requires transfusion.
-This classification is not steadfast, and can change slightly depending on an individual's physical shape - typically with cardiovascular health.
-Elderly individuals usually have less tolerance to blood loss, and cannot easily compensate.
-Depending on the blood vessel severed, death can take longer or shorter to occur
-Jugular vein, carotid artery, femoral artery/vein, subclavian artery/vein lead to blood loss within around 2 minutes.
-Carotid/Jugular severing typically leads to unconsciousness within 10-20 seconds.
-Vena cava and the descending aorta lead to blood loss within 30-60 seconds.
-Aortic arch, pulmonary system or the heart itself leads to almost instant death.
Trauma Types:
-Trauma itself typically does not kill, however it is damage to individual bodily organs or blood loss that does
-Method and time of death depend on many factors such as the type of trauma, the instrument used, location of the trauma, as well as its quality. It is therefore impossible to create a guide that accurately gives details on its effects.
-Trauma can however leave an individual open to disease, further trauma through open wounds, or indirectly cause haemorrhaging.
-Blunt trauma delivers it over a surface area, and while skin may be unbroken, underlying tissue may be damaged - this is typically seen with blunt force trauma to the head.
-Penetrating trauma is one of the most dangerous, due to the comparative lack of force needed and the laceration it can cause to internal organs and body tissue.
-Typical signs of internal bleeding are blood loss from the rectum, nose or ears (not super reliable).
-A general rule of thumb, is that if bleeding does not stop within 10 minutes of applying pressure, medical attention should be sought and stitches may be needed.
Other Names: Lockjaw
Infection: Introduction via puncture wounds (penetrative trauma). It is more common in hotter, damp climates with organically rich soil, typically fertilised by manure. It is typical to contract tetanus from rusted material due to the organism thriving in conditions that lack oxygen (rust typically consumes oxygen in its generation, making it an obvious indicator).
Symptoms: Mild spasms occur in the jaw (leading to the name lockjaw). Spasms can spread to facial muscles, as well as the chest, neck, back, abdominal and buttocks. Other symptoms include fever, headache, irritability, breathing problems, burning sensation from urination, urine retention, and incontinence.
Description: The spasm of back muscles causes the characteristic arching of the back, a rather disturbing sight. The farther the entry sight to the central nervous system, the longer it takes to incubate the pathogen - from around 10 days to several months. It also occurs in newborns whose umbilical stump has not been cut correctly, or cut with equipment that has not been sterilised.
Death: Mortality rate for tetanus, even treated, is usually around 10%. This is usually due to spasming of muscles, which may present breathing issues, causing respiratory failure and asphyxiation.
Blood Loss:
For more detail:
https://hollowworld.co.uk/threads/more-lengthy-tutorial-human-body-and-injury-blood-loss.27415/
However, to summarise:
-The adult body circulates around 5 litres of blood every minute
-Blood loss is caused by either trauma, a medical condition, or a combination of both
-Hemorrhaging (blood loss) is typically divided into Class I, II, III and IV
-Class I involves up to 15% blood loss (750mls or 1.6 pints) and typically does not affect vital signs, but can cause dizziness and lethargy
-Class II involves up to 15-30% blood loss (750mls-1500mls or 1.6-3.2 pints). This typically causes rapid heart beat, with the skin becoming pale and cool to the touch.
-Class III involves up to 30-40% blood loss (1500mls-2000mls or 3.2-4.2 pints). Blood pressure drops, heart beat increases and the individual enters shock. Blood transfusion is typically necessary at this point.
-Class IV involves any more than 40% blood loss (>2000mls or >4.2 pints). The individual is incredibly close to death and requires transfusion.
-This classification is not steadfast, and can change slightly depending on an individual's physical shape - typically with cardiovascular health.
-Elderly individuals usually have less tolerance to blood loss, and cannot easily compensate.
-Depending on the blood vessel severed, death can take longer or shorter to occur
-Jugular vein, carotid artery, femoral artery/vein, subclavian artery/vein lead to blood loss within around 2 minutes.
-Carotid/Jugular severing typically leads to unconsciousness within 10-20 seconds.
-Vena cava and the descending aorta lead to blood loss within 30-60 seconds.
-Aortic arch, pulmonary system or the heart itself leads to almost instant death.
Trauma Types:
-Trauma itself typically does not kill, however it is damage to individual bodily organs or blood loss that does
-Method and time of death depend on many factors such as the type of trauma, the instrument used, location of the trauma, as well as its quality. It is therefore impossible to create a guide that accurately gives details on its effects.
-Trauma can however leave an individual open to disease, further trauma through open wounds, or indirectly cause haemorrhaging.
-Blunt trauma delivers it over a surface area, and while skin may be unbroken, underlying tissue may be damaged - this is typically seen with blunt force trauma to the head.
-Penetrating trauma is one of the most dangerous, due to the comparative lack of force needed and the laceration it can cause to internal organs and body tissue.
-Typical signs of internal bleeding are blood loss from the rectum, nose or ears (not super reliable).
-A general rule of thumb, is that if bleeding does not stop within 10 minutes of applying pressure, medical attention should be sought and stitches may be needed.
Hygiene
I recognise that many races have progressed passed outdated Middle Age hygiene and cleanliness standards, however I still feel it justified to mention these issues related with hygiene and cleanliness. Some detail diseases caused by poor food preparation, lack of cleanliness, as well as some historical Middle Age patterns that often lead to infection.
Dysentery:
Other Names: Flux, Diarrhoea, Runs
Infection: Fecal contaminations of food and water. Often due to poor hygiene, poor sanitation and is incredibly common in impoverished areas. Often through unwashed foodstuffs during preparation (lots of crops grew in farmland fertilised with human waste).
Symptoms: Blood and mucous in diarrhoea. Can also include fever, and abdominal pain. Frequently causes dehydration. Severe cases cause rapid weight loss, with occasional nausea and vomiting.
Description: Inflammation of the intestine, a type of gastroenteritis. Usually identified from the mouth, skin and lips being dry and cracked from dehydration. Due to the inflammatory nature, it can cause cramping, intestinal swelling from capillaries (odema). Can often lead to onset of anemia via blood loss through stool.
Death: Leading cause of death in the 14th century, and incredibly difficult to treat due to the lack of antibiotics. Causes death by dehydration which can occur anywhere from 3-14 days depending on overall health, hydration and immunity. If battled off, it can cause chronic anemia. Increased to around 90% of deaths in some regions of Europe during the 18th century.
Typhoid:
Other Names: Typhoid Fever, Nervous Fever
Infection: The bacteria is spread through the fecal-oral route from currently infected and asymptomatic carriers. This is due to poor sanitation, hygiene, and contaminated food and water. An asymptomatic carrier is defined as one who continues to excrete typhoid bacteria a year after acute stage of infection.
Symptoms: The illness is divided into four distinct sections, lasting around 7 days each. Days 1-7, body temperature rises, fever fluctuations, headache and cough, some people experience nose bleeds as well as abdominal pain. Days 8-14, a high fever occurs as well as lethargy, with patients experiencing delirium and becoming agitated, lending it the name Nervous Fever. Rose spots also appear on the chest of around a third of patients. A rattling breathing sound can be heard from the lungs. Diarrhoea occurs, but constipation can also appear. Days 15-21, a number of complications occur which often lead to death; intestinal haemorrhaging, intestinal perforation (this is a silent killer as it is only detected once it causes septicaemia), encephalitis (inflammation of the brain causing headache, fever, confusion, seizures, hallucinations etc.), respiratory diseases like pneumonia and bronchitis, neuropsychiatric symptoms such as muttering delirium/coma vigil, metastatic (spreads elsewhere from where it originated) abscesses, cholecystitis (inflammation of the gallbladder), endocarditis (inflammation of inner heart muscle), and osteitis (inflammation of the bone). Days 22-28, previous symptoms persist with a very high fever often continuing.
Description: This disease is one of the more brutal, and is caused by a Salmonella bacterium. Symptoms may vary from mild to severe, but usually occur 6-30 days from exposure, with a gradual onset of a high fever. Without treatment, symptoms can last from weeks to months.
Death: I’m sure you can use your imagination.
Polio:
Other Names: Infantile Paralysis
Infection: Incredibly contagious through the fecal-oral route, with peak transmission during summer and autumn in more temperate climates. Exposure and first symptoms usually occur within 6-20 days of each other.
Symptoms: In the event of minor illness, flu like symptoms occur along with nausea, vomiting and diarrhoea. In the event of major illness, a number of symptoms can occur
Description: Polio has roughly three types of outcomes, known as asymptomatic (72%), minor if it does not involve the Central Nervous System (24% of cases), and major if it does involve the CNS (1-5%). Major cases cause roughly nonparalytic meningitis (brain inflammation), acute flaccid paralysis and encephalitis (brain infection) rarely in infants.
Death: Death usually occurs either through seizures, or by paralysing muscles required for breathing, causing the individual to asphyxiate.
Salmonellosis:
Other Names: Food Poisoning
Infection: Contaminated foodstuffs, raw meats (reptiles, poultry, rodents, small mammals, occasionally farm animals), poor kitchen hygiene, polluted water via fecal-oral route. It is incredibly rare to get it from raw eggs, but still possible.
Symptoms: Diarrhoea, fever, vomiting, intestinal inflammation which causes water stool (occasionally bloody).
Description: Common food poisoning, slightly different to dysentery which is generally contaminated foodstuffs. Most notably from poorly prepared chicken and turkey. If the bacteria manages to enter the body's lymphatic system, it can however cause typhoid.
Death: Death is uncommon from salmonella poisoning, however it can cause sepsis in immunocompromised. Infants, small children and the elderly can also die due to dehydration which causes meningitis. It can also cause the development of typhoid if entering the lymphatic system.
Other Names: Flux, Diarrhoea, Runs
Infection: Fecal contaminations of food and water. Often due to poor hygiene, poor sanitation and is incredibly common in impoverished areas. Often through unwashed foodstuffs during preparation (lots of crops grew in farmland fertilised with human waste).
Symptoms: Blood and mucous in diarrhoea. Can also include fever, and abdominal pain. Frequently causes dehydration. Severe cases cause rapid weight loss, with occasional nausea and vomiting.
Description: Inflammation of the intestine, a type of gastroenteritis. Usually identified from the mouth, skin and lips being dry and cracked from dehydration. Due to the inflammatory nature, it can cause cramping, intestinal swelling from capillaries (odema). Can often lead to onset of anemia via blood loss through stool.
Death: Leading cause of death in the 14th century, and incredibly difficult to treat due to the lack of antibiotics. Causes death by dehydration which can occur anywhere from 3-14 days depending on overall health, hydration and immunity. If battled off, it can cause chronic anemia. Increased to around 90% of deaths in some regions of Europe during the 18th century.
Typhoid:
Other Names: Typhoid Fever, Nervous Fever
Infection: The bacteria is spread through the fecal-oral route from currently infected and asymptomatic carriers. This is due to poor sanitation, hygiene, and contaminated food and water. An asymptomatic carrier is defined as one who continues to excrete typhoid bacteria a year after acute stage of infection.
Symptoms: The illness is divided into four distinct sections, lasting around 7 days each. Days 1-7, body temperature rises, fever fluctuations, headache and cough, some people experience nose bleeds as well as abdominal pain. Days 8-14, a high fever occurs as well as lethargy, with patients experiencing delirium and becoming agitated, lending it the name Nervous Fever. Rose spots also appear on the chest of around a third of patients. A rattling breathing sound can be heard from the lungs. Diarrhoea occurs, but constipation can also appear. Days 15-21, a number of complications occur which often lead to death; intestinal haemorrhaging, intestinal perforation (this is a silent killer as it is only detected once it causes septicaemia), encephalitis (inflammation of the brain causing headache, fever, confusion, seizures, hallucinations etc.), respiratory diseases like pneumonia and bronchitis, neuropsychiatric symptoms such as muttering delirium/coma vigil, metastatic (spreads elsewhere from where it originated) abscesses, cholecystitis (inflammation of the gallbladder), endocarditis (inflammation of inner heart muscle), and osteitis (inflammation of the bone). Days 22-28, previous symptoms persist with a very high fever often continuing.
Description: This disease is one of the more brutal, and is caused by a Salmonella bacterium. Symptoms may vary from mild to severe, but usually occur 6-30 days from exposure, with a gradual onset of a high fever. Without treatment, symptoms can last from weeks to months.
Death: I’m sure you can use your imagination.
Polio:
Other Names: Infantile Paralysis
Infection: Incredibly contagious through the fecal-oral route, with peak transmission during summer and autumn in more temperate climates. Exposure and first symptoms usually occur within 6-20 days of each other.
Symptoms: In the event of minor illness, flu like symptoms occur along with nausea, vomiting and diarrhoea. In the event of major illness, a number of symptoms can occur
Description: Polio has roughly three types of outcomes, known as asymptomatic (72%), minor if it does not involve the Central Nervous System (24% of cases), and major if it does involve the CNS (1-5%). Major cases cause roughly nonparalytic meningitis (brain inflammation), acute flaccid paralysis and encephalitis (brain infection) rarely in infants.
Death: Death usually occurs either through seizures, or by paralysing muscles required for breathing, causing the individual to asphyxiate.
Salmonellosis:
Other Names: Food Poisoning
Infection: Contaminated foodstuffs, raw meats (reptiles, poultry, rodents, small mammals, occasionally farm animals), poor kitchen hygiene, polluted water via fecal-oral route. It is incredibly rare to get it from raw eggs, but still possible.
Symptoms: Diarrhoea, fever, vomiting, intestinal inflammation which causes water stool (occasionally bloody).
Description: Common food poisoning, slightly different to dysentery which is generally contaminated foodstuffs. Most notably from poorly prepared chicken and turkey. If the bacteria manages to enter the body's lymphatic system, it can however cause typhoid.
Death: Death is uncommon from salmonella poisoning, however it can cause sepsis in immunocompromised. Infants, small children and the elderly can also die due to dehydration which causes meningitis. It can also cause the development of typhoid if entering the lymphatic system.
General Pathogens
This area considers diseases often spread from person to person, or animal to person that don't often rely on personal hygiene - moreso chance of encountering someone infected.
Tuberculosis:
Other Names: Consumption, Phthisis, White Plague.
Infection: An airborne pathogen spread from an individual with active TB through fluids by coughing, spitting, speaking or sneezing.
Symptoms: A chronic, heavy cough with blood-containing mucus, fever, night sweats, and severe weight loss.
Description: A bacterium primarily affects the lungs, but can occur in other parts of the body. Most infections are known as latent TB, where no symptoms are expressed and individuals cannot spread the disease - only around 10% of latent TB progress to active TB. Active infection typically occurs more in people HIV/AIDS positive and those who smoke. Other risk factors include alcoholism and diabetes.
Death: TB could not be treated in any way before the 19th century, and thus it is chronic infection during this time. Untreated TB has a 33% mortality rate within two years, and 66% within five. TB kills by caseation, where tissue is destroyed, causing dramatic weight loss (as if being consumed). Death occurs through multiple organ failure, internal haemorrhaging (bleeding) within the lungs, and lung collapse.
Leprosy:
Other Names: N/A
Infection: Spread through cough or nasal fluid via sneezing. 95% of people who contract the pathogen do not actually develop leprosy. Genetics and immunity play a large role in preventing disease development - it cannot pass between a mother to an unborn child, nor is it sexually transmitted. Average incubation time for the disease is around 5 years, and symptoms can take up to 20 years to develop.
Symptoms: Can cause loss of fingers and toes, gangrene, blindness, collapse of the nose, ulcerations, lesions and weakening of skeletal frame. Common signs also include runny nose, dry scalp, poor speech due to deteriorating vocal cords, as well as the atrophy (deterioration) of testes, which can lead to impotence in males. Around 30% of lepers experience nerve damage - which becomes permanent if there is not appropriate treatment within around 3 months. This can lead to loss of muscle function, and eventually paralysis. Also includes numbness, which leads to additional infections.
Description: A long-term pathogenic disease that usually results in nerve damage. This causes a lack of ability to feel pain, which in turn often leads to individuals unknowingly damaging body parts until that limb/digit has biologically “died”.
Death: Leprosy itself does not kill you, however the results from infection will most certainly make a person incredibly susceptible to further disease, and is thus considered a high risk patient. As such, leprosy often results in death. Historically, it was seen as a spiritual disease and thus many treatments relied on spirituality, as medicine was ineffective at this time.
Influenza:
Other Names: Flu, Common Cold
Infection: Person to person contact, with the inhalation of aerosol droplets of the virus.
Symptoms: High fever, runny nose, sore throat, muscle and joint pain, headache, coughing and lethargy. These occur around 2 days after exposure to the virus and persist around a week. Diarrhoea and vomiting can also occur in children. Complications often lead to pneumonia, sinus infections as well as worsening asthma and heart conditions.
Description: An incredibly common disease that typically only lasts around 1 week, however some symptoms may persist for more than two weeks. This disease weakens the immune system by taking up its resources. Whilst causing the common cold, it can prove fatal to some individuals.
Death: This often does not often explicitly kill people, however it often leads to the onset of other diseases due to immunocompromisation. There are many different variations of this disease and thus many different methods of mortality.
Smallpox:
Other Names: Pox, Red Plague
Infection: Person to person contact, with the inhalation of aerosol droplets of the virus - typically from oral, nasal or pharyngeal (throat) mucous.
Symptoms: Initial symptoms include fever and vomiting, sores in the mouth and a skin rash. This rash turns into a mass of fluid-filled bumps that have an indentation in its centre.
Description: The disease carries an ordinary and a malignant form, with ordinary affecting 90% of people who contract it. This is when over the course of three weeks, the bumps enlarge, spew pus, deflate and fall off the skin, leaving scars behind. These scars have a high density on the face, especially the forehead. Malignant pox is however much more prevalent in children, where the bumps occur but instead grow into the skin, rather than on top.
Death: Death by ordinary smallpox was rare, as it was mostly just a skin condition, but could leave horrible scarring (often confused for chicken pox). However, for malignant pox, it was almost always fatal, as the bumps would haemorrhage and release bacteria into the blood, causing toxemia. If not however, no scars would persist.
Pertussis:
Other Names: Whooping Cough
Infection: Person to person contact, with inhalation of aerosol droplets of the virus typically from coughing and sneezing.
Symptoms: Classic symptoms include sudden and intense high pitched coughs, fainting, and vomiting after coughing. Symptoms are usually similar to a common cold, but the cough persists for weeks, sometimes up to 10.
Description: Pertussis was not particularly common in the Middle Ages, but it still was deadly for younger children. The intensity of the coughs often lead to rib fractures, hernias, tears in vertebral arteries, involuntary urination as well as bursting blood vessels in the eyes.
Death: It is typically newborn infants to young toddlers who perish from the disease, as it occasionally causes them to cease breathing for periods of time. This can lead to asphyxiation, or brain damage due to lack of oxygen, and thus cause seizures and brain damage. It can also lead to the development of pneumonia.
Bacterial Meningitis:
Other Names: N/A
Infection: It is a catch all illness from a variety of different bacteria, but it usually can occur through coughing and sneezing, saliva and spit, poorly prepared food (fecal-oral route), and through childbirth.
Symptoms: Usually sudden, occurring around 3-7 days after exposure, with an onset of a fever, headache and a stiff neck. This is usually followed by nausea, vomiting, sensitivity to light and confusion. Newborns can be exposed, yet it is much more difficult to notice. Classic symptoms include slowness or inactivity, irritability, vomiting and poor diet.
Description: The general, usually acute inflammation of the brain’s meninges (coverings of the brain and spine).
Death: Occurs as little as a few hours, as it is deadly without appropriate treatment (antibiotics). As such, it is essentially a death sentence during this setting. This is usually through sudden and sporadic seizures, followed by a coma.
Pneumonia:
Other Names: N/A
Infection: There are several causes for pneumonia. If it can cause some degree of lung inflammation, it can cause pneumonia. It usually only presents itself once an immune system is already compromised, which can be from hospitalisation, chronic disease (e.g. asthma, heart disease), smoking, lack of hand washing, liver disease, and general old age. Additional risks are for children under the age of 2, not being breastfed, malnutrition and poverty.
Symptoms: Characterised by a productive cough, fever, shaking chills, shortness of breath, chest pains, and increased breathing. Confusion is common in the elderly. More severe symptoms in children can be blue-tinged skin, convulsions, extremes of temperature, ongoing vomiting or decreased level of consciousness.
Description: A general term for bacterial infection of the lungs. It essentially causes inflammation in air sacs, causing them to flood with fluid. It can usually be mild, but potentially deadly, especially in the already sick or elderly.
Death: Severe pneumonia can kill within hours, as the individual is essentially drowning in the fluids within their lungs, which will thicken into phlegm. Asphyxiation usually is the cause of death.
Septicemia (Sepsis):
Other Names: Blood Poisoning
Infection: Bacteria migrate from a pre-existing infection within the skin, lungs, urinary tract, digestive system, bladder, kidneys and others, to become systemic throughout the entire body via the blood-stream.
Symptoms: Symptoms of the existing infection occur along with a fever, a low body temperature, rapid breathing, fast heart rate, confusion, swelling, and decreased urination.
Description: Septicemia is when bacteria enter the bloodstream, which causes sepsis - the response to infection that often leads to tissue damage, organ failure and death.
Death: The drop in blood pressure can induce septic shock, which causes organ failure across the entire body, as blood oxygen level is nullified. This characteristically leads to respiratory/heart failure, a stroke, and eventually death. It is much more common to see young children and the elderly enter septic shock. Treatment requires fluid exchange, antibiotics and vasopressors, however during this time period, it is essentially a death sentence.
Other Names: Consumption, Phthisis, White Plague.
Infection: An airborne pathogen spread from an individual with active TB through fluids by coughing, spitting, speaking or sneezing.
Symptoms: A chronic, heavy cough with blood-containing mucus, fever, night sweats, and severe weight loss.
Description: A bacterium primarily affects the lungs, but can occur in other parts of the body. Most infections are known as latent TB, where no symptoms are expressed and individuals cannot spread the disease - only around 10% of latent TB progress to active TB. Active infection typically occurs more in people HIV/AIDS positive and those who smoke. Other risk factors include alcoholism and diabetes.
Death: TB could not be treated in any way before the 19th century, and thus it is chronic infection during this time. Untreated TB has a 33% mortality rate within two years, and 66% within five. TB kills by caseation, where tissue is destroyed, causing dramatic weight loss (as if being consumed). Death occurs through multiple organ failure, internal haemorrhaging (bleeding) within the lungs, and lung collapse.
Leprosy:
Other Names: N/A
Infection: Spread through cough or nasal fluid via sneezing. 95% of people who contract the pathogen do not actually develop leprosy. Genetics and immunity play a large role in preventing disease development - it cannot pass between a mother to an unborn child, nor is it sexually transmitted. Average incubation time for the disease is around 5 years, and symptoms can take up to 20 years to develop.
Symptoms: Can cause loss of fingers and toes, gangrene, blindness, collapse of the nose, ulcerations, lesions and weakening of skeletal frame. Common signs also include runny nose, dry scalp, poor speech due to deteriorating vocal cords, as well as the atrophy (deterioration) of testes, which can lead to impotence in males. Around 30% of lepers experience nerve damage - which becomes permanent if there is not appropriate treatment within around 3 months. This can lead to loss of muscle function, and eventually paralysis. Also includes numbness, which leads to additional infections.
Description: A long-term pathogenic disease that usually results in nerve damage. This causes a lack of ability to feel pain, which in turn often leads to individuals unknowingly damaging body parts until that limb/digit has biologically “died”.
Death: Leprosy itself does not kill you, however the results from infection will most certainly make a person incredibly susceptible to further disease, and is thus considered a high risk patient. As such, leprosy often results in death. Historically, it was seen as a spiritual disease and thus many treatments relied on spirituality, as medicine was ineffective at this time.
Influenza:
Other Names: Flu, Common Cold
Infection: Person to person contact, with the inhalation of aerosol droplets of the virus.
Symptoms: High fever, runny nose, sore throat, muscle and joint pain, headache, coughing and lethargy. These occur around 2 days after exposure to the virus and persist around a week. Diarrhoea and vomiting can also occur in children. Complications often lead to pneumonia, sinus infections as well as worsening asthma and heart conditions.
Description: An incredibly common disease that typically only lasts around 1 week, however some symptoms may persist for more than two weeks. This disease weakens the immune system by taking up its resources. Whilst causing the common cold, it can prove fatal to some individuals.
Death: This often does not often explicitly kill people, however it often leads to the onset of other diseases due to immunocompromisation. There are many different variations of this disease and thus many different methods of mortality.
Smallpox:
Other Names: Pox, Red Plague
Infection: Person to person contact, with the inhalation of aerosol droplets of the virus - typically from oral, nasal or pharyngeal (throat) mucous.
Symptoms: Initial symptoms include fever and vomiting, sores in the mouth and a skin rash. This rash turns into a mass of fluid-filled bumps that have an indentation in its centre.
Description: The disease carries an ordinary and a malignant form, with ordinary affecting 90% of people who contract it. This is when over the course of three weeks, the bumps enlarge, spew pus, deflate and fall off the skin, leaving scars behind. These scars have a high density on the face, especially the forehead. Malignant pox is however much more prevalent in children, where the bumps occur but instead grow into the skin, rather than on top.
Death: Death by ordinary smallpox was rare, as it was mostly just a skin condition, but could leave horrible scarring (often confused for chicken pox). However, for malignant pox, it was almost always fatal, as the bumps would haemorrhage and release bacteria into the blood, causing toxemia. If not however, no scars would persist.
Pertussis:
Other Names: Whooping Cough
Infection: Person to person contact, with inhalation of aerosol droplets of the virus typically from coughing and sneezing.
Symptoms: Classic symptoms include sudden and intense high pitched coughs, fainting, and vomiting after coughing. Symptoms are usually similar to a common cold, but the cough persists for weeks, sometimes up to 10.
Description: Pertussis was not particularly common in the Middle Ages, but it still was deadly for younger children. The intensity of the coughs often lead to rib fractures, hernias, tears in vertebral arteries, involuntary urination as well as bursting blood vessels in the eyes.
Death: It is typically newborn infants to young toddlers who perish from the disease, as it occasionally causes them to cease breathing for periods of time. This can lead to asphyxiation, or brain damage due to lack of oxygen, and thus cause seizures and brain damage. It can also lead to the development of pneumonia.
Bacterial Meningitis:
Other Names: N/A
Infection: It is a catch all illness from a variety of different bacteria, but it usually can occur through coughing and sneezing, saliva and spit, poorly prepared food (fecal-oral route), and through childbirth.
Symptoms: Usually sudden, occurring around 3-7 days after exposure, with an onset of a fever, headache and a stiff neck. This is usually followed by nausea, vomiting, sensitivity to light and confusion. Newborns can be exposed, yet it is much more difficult to notice. Classic symptoms include slowness or inactivity, irritability, vomiting and poor diet.
Description: The general, usually acute inflammation of the brain’s meninges (coverings of the brain and spine).
Death: Occurs as little as a few hours, as it is deadly without appropriate treatment (antibiotics). As such, it is essentially a death sentence during this setting. This is usually through sudden and sporadic seizures, followed by a coma.
Pneumonia:
Other Names: N/A
Infection: There are several causes for pneumonia. If it can cause some degree of lung inflammation, it can cause pneumonia. It usually only presents itself once an immune system is already compromised, which can be from hospitalisation, chronic disease (e.g. asthma, heart disease), smoking, lack of hand washing, liver disease, and general old age. Additional risks are for children under the age of 2, not being breastfed, malnutrition and poverty.
Symptoms: Characterised by a productive cough, fever, shaking chills, shortness of breath, chest pains, and increased breathing. Confusion is common in the elderly. More severe symptoms in children can be blue-tinged skin, convulsions, extremes of temperature, ongoing vomiting or decreased level of consciousness.
Description: A general term for bacterial infection of the lungs. It essentially causes inflammation in air sacs, causing them to flood with fluid. It can usually be mild, but potentially deadly, especially in the already sick or elderly.
Death: Severe pneumonia can kill within hours, as the individual is essentially drowning in the fluids within their lungs, which will thicken into phlegm. Asphyxiation usually is the cause of death.
Septicemia (Sepsis):
Other Names: Blood Poisoning
Infection: Bacteria migrate from a pre-existing infection within the skin, lungs, urinary tract, digestive system, bladder, kidneys and others, to become systemic throughout the entire body via the blood-stream.
Symptoms: Symptoms of the existing infection occur along with a fever, a low body temperature, rapid breathing, fast heart rate, confusion, swelling, and decreased urination.
Description: Septicemia is when bacteria enter the bloodstream, which causes sepsis - the response to infection that often leads to tissue damage, organ failure and death.
Death: The drop in blood pressure can induce septic shock, which causes organ failure across the entire body, as blood oxygen level is nullified. This characteristically leads to respiratory/heart failure, a stroke, and eventually death. It is much more common to see young children and the elderly enter septic shock. Treatment requires fluid exchange, antibiotics and vasopressors, however during this time period, it is essentially a death sentence.
Parasites
Any disease caused by exposure to some parasitic entity, such as fleas, mites or mosquitos.
Bubonic Plague:
Other Names: Black Death, Pestilence, Great Mortality
Infection: Results from the bite of an infected flea. However, very rarely, it can be transmitted via direct contact with infected tissue or exposure to the cough of another person with the Bubonic Plague.
Symptoms: Most famous symptom is infected, enlarged and painful lymph nodes, which are termed buboes. These buboes are commonly in the armpits, upper femoral, groin and neck region. These usually occur several days after exposure. Other symptoms include chills, fever, cramps, seizures, pain, and gangrene, heavy breathing, vomiting of blood, and extreme pain due to skin decomposition and necrosis.
Description: One of the three primary diseases composing the Black Death. This is the primary form of the disease and often develops into septicemic or pneumonic. This disease was the cause of around 50 million deaths in Europe, around 25-60% of the population.
Death: Without treatment, it results in the death of around 30-90% of those infected within 10 days. With treatment, this drops to 10%. Symptoms progress to include fatigue, black spots, delirium, coma and then eventually death.
Septicemic Plague:
Other Names: Black Death, Pestilence, Great Mortality
Infection: Similar infection to bubonic, however bubonic plague is the main cause of septicemic as the disease becomes systemic, and infects the blood. If the disease enters the blood specifically, it will multiply and cause sepsis, not septicemic plague.
Symptoms: Abdominal pain, bleeding under skin, from mouth, nose and rectum, diarrhoea, fever, chills, low blood pressure, nausea, organ failure, vomiting (w/ blood), sepsis, poor breathing, tissue death (gangrene) and shock.
Description: One of the three primary diseases composing the Black Death. This is typically when the bacteria responsible infects the bloodstream, it is the rarest form of Black Death.
Death: Death usually results via sepsis, lung collapse or bodily shock. There is no treatment without antibiotics. Untreated septicemic plague is always fatal, as it must be treated within 24 hours. Some people may die on the day they contract the disease also.
Pneumonic Plague:
Other Names: Black Death, Pestilence, Great Mortality
Infection: Primary infection occurs from inhalation of the bacteria directly from other humans as well as felines, secondary infection occurs when septicemic plague spreads from the bloodstream into the lung tissue.
Symptoms: Most common symptom is heavy coughing, often containing blood. Early signs also include fever, headache, weakness, along with rapidly developing pneumonia, along with shortness of breath, chest pain, and bloody or watery sputum (saliva and discharge from respiratory passages). Symptoms typically occur 3-7 days after exposure.
Description: One of the three primary diseases composing the Black Death.
Death: Untreated pneumonic plague has a mortality rate of 100%, dying within a couple days from pneumonia.
Malaria:
Other Names: Ague, Marsh/Swamp Fever, Paludism
Infection: Mosquito-borne, leading to it being more common in tropical or subtropical areas. There are 5 known variations of the bacteria causing malaria. Historically however, this disease was believed to have been caused by “bad air”.
Symptoms: Flu-like symptoms occur 8-25 days after infection, and resemble conditions such as sepsis and gastroenteritis. Often includes headache, fever, shivering, joint pain, vomiting, anemia, jaundice, retinal damage and convulsions. The most famous symptom is paroxysm which is the cyclical occurrence of sudden coldness followed by shivering, fever and sweating, occurring every 2-3 days. Severe malaria arises 9-30 days after infection, and can cause cerebral malaria. This typically causes neurological symptoms such as seizures, coma, involuntary flexion of the arms and legs, involuntary eye movement, as well as a failure of the eyes to turn together in the same direction. Another infamous symptom is the state of severe hyperextension and spasticity in which an individual’s head, neck and spinal column enter a bridging or arching position.
Description: A parasitic disease spread by mosquito bites. This is mostly found in the warmer climates as the mosquito typically cannot survive in cold or frigid environments.
Death: Death usually occurs due to complications in symptoms, most notably being respiratory distress - occurring in 25% of adults and 40% of children. This can happen due to metabolic acidosis (imbalance of electrolytes), pulmonary oedema (fluid build-up in the lungs), pneumonia and severe anaemia. Coinfection with HIV increases mortality, and can often cause kidney failure, known as Blackwater fever, where red blood cells burst and are released through the urine. Infection in pregnant women causes stillbirths, infant mortality and low birth weight.
Extraneous Circumstances
This includes any specific situation with a likelihood of death.
Dehydration:
What: Lack of water in your body which leads to liver and kidney failure.
How: General thirst occurs when around 2% of body weight is lost (roughly equivalent to exercising in a hot room for an hour with no drink). Fainting occurs when around 4% of body weight is lost (roughly equivalent to going without water for 2 days, or extraneous exercise for three hours in extreme heat). Organ damage occurs when around 7% of body weight is lost (roughly equivalent to exercising for eight hours continuously in a hot room). Death is common upon loss of 10% which is the equivalent of going 5 days without water, or extraneous exercise for 11 hours in 30 degree (celcius) weather.
How long: It differs greatly depending on body mass, climate and salinity of the water. However, if around 10% of body weight is lost, you are at a typical point of no return, where oral hydration can no longer fulfill your loss, needing intravenous hydration.
Symptoms: Darkening urine as water retention in the kidneys increases. Blood thickens and becomes more sluggish, as such, heart rate increases. During fainting spells, your blood is concentrated to the point that blood flow decreases. This causes your skin to shrivel. Lower blood pressure causes fainting, and you essentially stop sweating - this makes you prone to overheating. Organ failure occurs as your body has trouble maintaining blood pressure, so it slows blood flow to non-vital organs, such as the kidneys and gut. Loss of kidney function causes cellular waste to quickly build up. Your uncontrollable body temperature means your vital organs overheat, and your liver will fail.
Death: Death occurs when around 10% of your body weight is lost. It is typically seen as an easier way to die, as it is not very painful. Headaches and cramping can occur in the first couple segments, followed by some delirium. It can also cause a mild euphoria just before death.
Starvation:
What: Malnutrition caused by using more energy than the body has available - lack of food or body fat to supplement diet. It is typically characterised by loss of around a third of a person’s normal body weight. If this increases to 40% - death is almost inevitable.
How: A lot of cases are individual to each other, depending on an overabundance of one nutrient a person may get in their life, versus a rarity of another. For example, anaemia is commonly developed even after nourishment, due to the lack of iron in a diet. The brain needs consistent glucose in order to keep going, which is generally derived from blood sugar. However, in the absence of continuous food, the body firstly uses up stores of fatty tissue, and once they are consumed, it’s last step is to consume muscle mass - leading to a gaunt and frail appearance.
How long: This depends massively, but it’s a general rule of thumb for adults of around 3 weeks and up to 70 days - this limits moves up if the individual has a higher fatty tissue mass, as well as the opposite. Within days, the body consumes fat. Metabolism slows, and body temperature begins to become deregulated, kidney function becomes impaired and overall immunity weakens. Typically, females can survive slightly longer due to genetic predisposition to create more body fat than males.
Symptoms: Upon consuming almost all body fat, a lethargic feeling occurs, as well as painful hunger pangs. The heart, lungs, ovaries and testes shrink - body temperature drops and a constant chilly feeling occurs. Individuals are usually apathetic, withdrawn, as well as suffer flaky skin, change in hair colour, and bloating in lower limbs and abdomen.
Death: Few people die directly from starvation, but rather infectious disease caused by its onset, or individual organ failure due to lack of a specified nutrient. Hypothermia can occur when body temperature drops, as well as dehydration can occur as a side effect. At death’s door, the body typically suffers from one of two diseases - kwashiorkor and marasmus. Marasmus is from poor energy levels, which leads to weakened immunity and susceptibility to infection. Kwashiorkor is more common in children, which causes bloating and distended bellies - giving an appearance of being well-fed. Almost always, death is caused by a heart attack, as heart muscle is also consumed.
Asphyxiation:
What: A deficiency in the supply of oxygen to the lungs for a period of time.
How: Can potentially occur from polluted air, airway obstruction, constriction of airway, asthma, or simple blockage - it also includes carbon monoxide inhalation (from smoke), drowning, hanging, seizures, strangulation and respiratory diseases.
How long: Usually ranges from 2-5 minutes - after 5 minutes the brain becomes oxygen starved and typically either ceases function or suffers brain damage. This goes for general lack of air, however if the trachea is constricted (strangulation, hanging etc.), the pressure on the neck will reduce venous blood flow out of the brain, causing brain death within around 2-3 minutes.
Symptoms: Unconsciousness typically occurs after 1 minute as the brain shuts down non-vital. You typically feel uncomfortable hotness, followed by numbness as well as slight euphoria and delirium.
Death: Brain death occurs swiftly, as the brain shuts down swiftly - it is a relatively painless death as you go unconscious after around a minute.
Drowning:
What: Asphyxiation due to being submerged in a liquid, fluid typically flooding the lungs and causing similar effects to general asphyxiation.
How: A subset of asphyxiations, as they differ slightly. This is usually due to poor swimming submersion.
How long: Roughly depends on the salinity of the liquid - for the sake of example, I’ll discuss freshwater versus saltwater. Freshwater is quicker, usually taking from 5-20 minutes, whereas saltwater is slower and much more painful, taking from 5-30 minutes.
Symptoms: Similar symptoms to asphyxiation - hotness, euphoria and unconsciousness after a minute or two.
Death: Death is swifter in freshwater as the water entering the lungs enters the bloodstream quickly, causing blood cells to burst - as well as preventing intake of oxygen. This leads to a heart attack. In saltwater, it forces the blood out of the bloodstream and into the lungs, so you technically die from a mixture of water and blood in your lungs.
Childbirth:
What: Death to the mother during the act of giving birth. There were never sufficient pregnancy tests, monitoring of the health of the baby or mother, nor any resources due to pregnancy being seen as a private, woman-to-woman topic to discuss. Thus, it was all ultimately left up to chance - physicians and doctors rarely visited unless in extreme circumstances, but rather hired midwives if they had any money.
How: Childbirth in humanoid races is not particularly efficient - due to a fatal combination of a narrow pelvis and enormous heads of babies.
How long: Case by case basis.
Symptoms: N/A
Death: Around the 14th century, it is estimated that around 2-4% of mothers died in childbirth, and considering the average number of children born was five, 10-16% of women died during childbirth overall. This could be due to a myriad of complications such as narrow or deformed pelvis, fetal malpresentation (breech births/shoulder presentation), general infection, puerperal fever (known as child-bed fever or postpartum sepsis, it is an infection of either the placenta or uterus), postpartum haemorrhage, eclampsia (seizures from high blood pressure) or obstructed labour. General blood loss was a big factor, as due to sexist connotations, men often had a much higher protein diet which meant women had lower blood iron and bled out easier. Interestingly, the invention of cast iron potting lowered this due to iron leaching into food.
Infant Mortality:
What: Death during infancy.
How: Infancy is a dangerous time of life, especially for those in the 14th century. If a child could not be nursed, chances of contracting disease increased dramatically - as there were many unsanitary methods of feeding a child and without the lack of passive immunity from breast milk, the child has basically no immune system.
How long: N/A
Symptoms: N/A
Death: Disease, birthing, accidents, negligence and other factors. It is believed that almost 30% of newborns died within days of birth.
Hypothermia (Exposure):
What: Body heat cannot be generated fast enough at the rate you lose body heat - lowers body temperature.
How: This is typically due to prolonged exposure to extreme cold, such as winter weather or submersion in cold water. Many of the bodies natural processes require a steady body temperature to work optimally - organ failure occurs if this is in disarray for too long.
How long: Temperatures of 10 degrees celsius (50 degrees fahrenheit) water can kill in as little as an hour. Temperatures in water near freezing can kill in as little as 15 minutes.
Symptoms: There are usually three stages of severity. Mild hypothermia is when the body begins shivering, heart rate increases, respiratory rate increases, increased urine production, mental confusion. As hypothermia progresses to moderate, symptoms include amnesia, confusion, slurred speech, decreased reflexes and loss of fine motor skill. Severe hypothermia causes inflamed skin, hallucinations, lack of reflexes, fixed dilated pupils, and lack of shivering. 20-50% of hypothermia deaths involved paradoxical undressing (usually during moderate to severe hypothermia), where the person becomes disorientated, confused and aggressive. They feel a strange sense of hotness, and begin removing clothing - increasing rate of heat loss.
Death: Slowed cease of function, inability for organs to perform necessary function. Occasionally, just before death, individuals undergo terminal burrowing. This is known as “hide-and-die syndrome”, where people will enter small, enclosed spaces such as underneath beds and behind wardrobes. It usually occurs alongside paradoxical undressing.
Heart Attack:
What: Blocked artery prevents blood flow to the heart.
How: This usually occurs due to heart disease, with risk factors including high blood pressure, smoking, lack of exercise, obesity, high cholesterol diet, poor diet, excessive alcoholism, drugs, significant emotional distress and extreme cold.
How long: Mild heart attacks can last from several minutes, or severe heart attacks lasting several hours. On average, a heart attack lasts around 20 minutes. There is a possibility of almost instant death.
Symptoms: Chest pain is the most common symptom, a feeling of tightness, pressure or squeezing. Pain often radiates to the left arm, with a possibility of moving to the lower jaw, neck, right arm, back and upper abdomen. This may also be accompanied by sweating, nausea or vomiting (more common in females), and fainting. This can often lead to shock and sudden death. It is also possible to suffer a silent heart attack, causing 22-64% of heart attacks where the individual does not display symptoms, but suffers one nonetheless.
Death: Likelihood of heart attack and coinciding death increases with relative age, but it has a number of possible causes. Opioids are often used to help chest pain, but they do not improve the outcome. Heart attack has generally been the leading cause of death throughout history, with 25% of people perishing from it. 40-50% of heart attacks cause a fatality.
Stroke:
What: Poor blood flow to the brain, causing brain cell death. This can be due to lack of blood flow or hemorrhaging.
How: There are many factors that can cause or trigger a stroke, including high blood pressure, smoking (nicotine increases heart rate as well as cigarette smoke causes fatty buildup in neck artery, as well as thickening blood), heart disease, diet, weight and exercise, age, family history, and sex.
How long: Severe strokes can lead to death within minutes, or major health problems such as paralysis and loss of bodily function. Milder, non-fatal strokes may cause temporary weakness in an arm, leg, side of a body, slurred speech and forgetfulness, which may be permanent.
Symptoms: Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body, confusion, trouble speaking, difficulty understanding speech, issues seeing in one or both eyes, trouble walking, dizziness, loss of balance and coordination, severe headaches, seizures, vertigo, excessive reflexes, and breathing issues.
Death: Second most common cause of death, accounting for around 11% of deaths. The chance of having a stroke doubles every decade after around the age of 55 (or its equivalent). Females are less likely to suffer a stroke at the same age, however they have a tendency to have more at a later age - this makes recovery more difficult and thus death more likely.
Aneurysm:
What: Enlargement of an artery due to weakness in its wall which causes a bulge or distention - when it ruptures, it can typically be fatal. It can occur anywhere in the body, but is typical in the brain, upper heart, legs and spleen.
How: It is unclear as to the main triggers to an aneurysm, however there are certain risk factors including blocked arteries (heart pumps harder and can stress artery walls), plaque buildup, high blood pressure, tobacco use, alcoholism, low copper diet, high cholesterol and increasing age.
How long: Formation of an aneurysm can take years, however aneurysm ruptures can occur randomly, and can be triggered by mundane reasons or physical trauma.
Symptoms: Can trigger a stroke, seizures, brain damage, heart attack, coma, or death.
Death: Around 25% of aneurysm cases are fatal within the first 24 hours, with another 25% being fatal within six months. A ruptured brain aneurysm is the most dangerous, being fatal in about 50% of cases. Death can be immediately after rupture, or several months. It is excruciatingly painful which can cause shock before death.
What: Lack of water in your body which leads to liver and kidney failure.
How: General thirst occurs when around 2% of body weight is lost (roughly equivalent to exercising in a hot room for an hour with no drink). Fainting occurs when around 4% of body weight is lost (roughly equivalent to going without water for 2 days, or extraneous exercise for three hours in extreme heat). Organ damage occurs when around 7% of body weight is lost (roughly equivalent to exercising for eight hours continuously in a hot room). Death is common upon loss of 10% which is the equivalent of going 5 days without water, or extraneous exercise for 11 hours in 30 degree (celcius) weather.
How long: It differs greatly depending on body mass, climate and salinity of the water. However, if around 10% of body weight is lost, you are at a typical point of no return, where oral hydration can no longer fulfill your loss, needing intravenous hydration.
Symptoms: Darkening urine as water retention in the kidneys increases. Blood thickens and becomes more sluggish, as such, heart rate increases. During fainting spells, your blood is concentrated to the point that blood flow decreases. This causes your skin to shrivel. Lower blood pressure causes fainting, and you essentially stop sweating - this makes you prone to overheating. Organ failure occurs as your body has trouble maintaining blood pressure, so it slows blood flow to non-vital organs, such as the kidneys and gut. Loss of kidney function causes cellular waste to quickly build up. Your uncontrollable body temperature means your vital organs overheat, and your liver will fail.
Death: Death occurs when around 10% of your body weight is lost. It is typically seen as an easier way to die, as it is not very painful. Headaches and cramping can occur in the first couple segments, followed by some delirium. It can also cause a mild euphoria just before death.
Starvation:
What: Malnutrition caused by using more energy than the body has available - lack of food or body fat to supplement diet. It is typically characterised by loss of around a third of a person’s normal body weight. If this increases to 40% - death is almost inevitable.
How: A lot of cases are individual to each other, depending on an overabundance of one nutrient a person may get in their life, versus a rarity of another. For example, anaemia is commonly developed even after nourishment, due to the lack of iron in a diet. The brain needs consistent glucose in order to keep going, which is generally derived from blood sugar. However, in the absence of continuous food, the body firstly uses up stores of fatty tissue, and once they are consumed, it’s last step is to consume muscle mass - leading to a gaunt and frail appearance.
How long: This depends massively, but it’s a general rule of thumb for adults of around 3 weeks and up to 70 days - this limits moves up if the individual has a higher fatty tissue mass, as well as the opposite. Within days, the body consumes fat. Metabolism slows, and body temperature begins to become deregulated, kidney function becomes impaired and overall immunity weakens. Typically, females can survive slightly longer due to genetic predisposition to create more body fat than males.
Symptoms: Upon consuming almost all body fat, a lethargic feeling occurs, as well as painful hunger pangs. The heart, lungs, ovaries and testes shrink - body temperature drops and a constant chilly feeling occurs. Individuals are usually apathetic, withdrawn, as well as suffer flaky skin, change in hair colour, and bloating in lower limbs and abdomen.
Death: Few people die directly from starvation, but rather infectious disease caused by its onset, or individual organ failure due to lack of a specified nutrient. Hypothermia can occur when body temperature drops, as well as dehydration can occur as a side effect. At death’s door, the body typically suffers from one of two diseases - kwashiorkor and marasmus. Marasmus is from poor energy levels, which leads to weakened immunity and susceptibility to infection. Kwashiorkor is more common in children, which causes bloating and distended bellies - giving an appearance of being well-fed. Almost always, death is caused by a heart attack, as heart muscle is also consumed.
Asphyxiation:
What: A deficiency in the supply of oxygen to the lungs for a period of time.
How: Can potentially occur from polluted air, airway obstruction, constriction of airway, asthma, or simple blockage - it also includes carbon monoxide inhalation (from smoke), drowning, hanging, seizures, strangulation and respiratory diseases.
How long: Usually ranges from 2-5 minutes - after 5 minutes the brain becomes oxygen starved and typically either ceases function or suffers brain damage. This goes for general lack of air, however if the trachea is constricted (strangulation, hanging etc.), the pressure on the neck will reduce venous blood flow out of the brain, causing brain death within around 2-3 minutes.
Symptoms: Unconsciousness typically occurs after 1 minute as the brain shuts down non-vital. You typically feel uncomfortable hotness, followed by numbness as well as slight euphoria and delirium.
Death: Brain death occurs swiftly, as the brain shuts down swiftly - it is a relatively painless death as you go unconscious after around a minute.
Drowning:
What: Asphyxiation due to being submerged in a liquid, fluid typically flooding the lungs and causing similar effects to general asphyxiation.
How: A subset of asphyxiations, as they differ slightly. This is usually due to poor swimming submersion.
How long: Roughly depends on the salinity of the liquid - for the sake of example, I’ll discuss freshwater versus saltwater. Freshwater is quicker, usually taking from 5-20 minutes, whereas saltwater is slower and much more painful, taking from 5-30 minutes.
Symptoms: Similar symptoms to asphyxiation - hotness, euphoria and unconsciousness after a minute or two.
Death: Death is swifter in freshwater as the water entering the lungs enters the bloodstream quickly, causing blood cells to burst - as well as preventing intake of oxygen. This leads to a heart attack. In saltwater, it forces the blood out of the bloodstream and into the lungs, so you technically die from a mixture of water and blood in your lungs.
Childbirth:
What: Death to the mother during the act of giving birth. There were never sufficient pregnancy tests, monitoring of the health of the baby or mother, nor any resources due to pregnancy being seen as a private, woman-to-woman topic to discuss. Thus, it was all ultimately left up to chance - physicians and doctors rarely visited unless in extreme circumstances, but rather hired midwives if they had any money.
How: Childbirth in humanoid races is not particularly efficient - due to a fatal combination of a narrow pelvis and enormous heads of babies.
How long: Case by case basis.
Symptoms: N/A
Death: Around the 14th century, it is estimated that around 2-4% of mothers died in childbirth, and considering the average number of children born was five, 10-16% of women died during childbirth overall. This could be due to a myriad of complications such as narrow or deformed pelvis, fetal malpresentation (breech births/shoulder presentation), general infection, puerperal fever (known as child-bed fever or postpartum sepsis, it is an infection of either the placenta or uterus), postpartum haemorrhage, eclampsia (seizures from high blood pressure) or obstructed labour. General blood loss was a big factor, as due to sexist connotations, men often had a much higher protein diet which meant women had lower blood iron and bled out easier. Interestingly, the invention of cast iron potting lowered this due to iron leaching into food.
Infant Mortality:
What: Death during infancy.
How: Infancy is a dangerous time of life, especially for those in the 14th century. If a child could not be nursed, chances of contracting disease increased dramatically - as there were many unsanitary methods of feeding a child and without the lack of passive immunity from breast milk, the child has basically no immune system.
How long: N/A
Symptoms: N/A
Death: Disease, birthing, accidents, negligence and other factors. It is believed that almost 30% of newborns died within days of birth.
Hypothermia (Exposure):
What: Body heat cannot be generated fast enough at the rate you lose body heat - lowers body temperature.
How: This is typically due to prolonged exposure to extreme cold, such as winter weather or submersion in cold water. Many of the bodies natural processes require a steady body temperature to work optimally - organ failure occurs if this is in disarray for too long.
How long: Temperatures of 10 degrees celsius (50 degrees fahrenheit) water can kill in as little as an hour. Temperatures in water near freezing can kill in as little as 15 minutes.
Symptoms: There are usually three stages of severity. Mild hypothermia is when the body begins shivering, heart rate increases, respiratory rate increases, increased urine production, mental confusion. As hypothermia progresses to moderate, symptoms include amnesia, confusion, slurred speech, decreased reflexes and loss of fine motor skill. Severe hypothermia causes inflamed skin, hallucinations, lack of reflexes, fixed dilated pupils, and lack of shivering. 20-50% of hypothermia deaths involved paradoxical undressing (usually during moderate to severe hypothermia), where the person becomes disorientated, confused and aggressive. They feel a strange sense of hotness, and begin removing clothing - increasing rate of heat loss.
Death: Slowed cease of function, inability for organs to perform necessary function. Occasionally, just before death, individuals undergo terminal burrowing. This is known as “hide-and-die syndrome”, where people will enter small, enclosed spaces such as underneath beds and behind wardrobes. It usually occurs alongside paradoxical undressing.
Heart Attack:
What: Blocked artery prevents blood flow to the heart.
How: This usually occurs due to heart disease, with risk factors including high blood pressure, smoking, lack of exercise, obesity, high cholesterol diet, poor diet, excessive alcoholism, drugs, significant emotional distress and extreme cold.
How long: Mild heart attacks can last from several minutes, or severe heart attacks lasting several hours. On average, a heart attack lasts around 20 minutes. There is a possibility of almost instant death.
Symptoms: Chest pain is the most common symptom, a feeling of tightness, pressure or squeezing. Pain often radiates to the left arm, with a possibility of moving to the lower jaw, neck, right arm, back and upper abdomen. This may also be accompanied by sweating, nausea or vomiting (more common in females), and fainting. This can often lead to shock and sudden death. It is also possible to suffer a silent heart attack, causing 22-64% of heart attacks where the individual does not display symptoms, but suffers one nonetheless.
Death: Likelihood of heart attack and coinciding death increases with relative age, but it has a number of possible causes. Opioids are often used to help chest pain, but they do not improve the outcome. Heart attack has generally been the leading cause of death throughout history, with 25% of people perishing from it. 40-50% of heart attacks cause a fatality.
Stroke:
What: Poor blood flow to the brain, causing brain cell death. This can be due to lack of blood flow or hemorrhaging.
How: There are many factors that can cause or trigger a stroke, including high blood pressure, smoking (nicotine increases heart rate as well as cigarette smoke causes fatty buildup in neck artery, as well as thickening blood), heart disease, diet, weight and exercise, age, family history, and sex.
How long: Severe strokes can lead to death within minutes, or major health problems such as paralysis and loss of bodily function. Milder, non-fatal strokes may cause temporary weakness in an arm, leg, side of a body, slurred speech and forgetfulness, which may be permanent.
Symptoms: Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body, confusion, trouble speaking, difficulty understanding speech, issues seeing in one or both eyes, trouble walking, dizziness, loss of balance and coordination, severe headaches, seizures, vertigo, excessive reflexes, and breathing issues.
Death: Second most common cause of death, accounting for around 11% of deaths. The chance of having a stroke doubles every decade after around the age of 55 (or its equivalent). Females are less likely to suffer a stroke at the same age, however they have a tendency to have more at a later age - this makes recovery more difficult and thus death more likely.
Aneurysm:
What: Enlargement of an artery due to weakness in its wall which causes a bulge or distention - when it ruptures, it can typically be fatal. It can occur anywhere in the body, but is typical in the brain, upper heart, legs and spleen.
How: It is unclear as to the main triggers to an aneurysm, however there are certain risk factors including blocked arteries (heart pumps harder and can stress artery walls), plaque buildup, high blood pressure, tobacco use, alcoholism, low copper diet, high cholesterol and increasing age.
How long: Formation of an aneurysm can take years, however aneurysm ruptures can occur randomly, and can be triggered by mundane reasons or physical trauma.
Symptoms: Can trigger a stroke, seizures, brain damage, heart attack, coma, or death.
Death: Around 25% of aneurysm cases are fatal within the first 24 hours, with another 25% being fatal within six months. A ruptured brain aneurysm is the most dangerous, being fatal in about 50% of cases. Death can be immediately after rupture, or several months. It is excruciatingly painful which can cause shock before death.
Please let me know if I got something incorrect or you have any questions! Any and all feedback is appreciated.
